Inhibition of the renin-angiotensin system prevents re-hospitalization of heart failure patients with preserved ejection fraction.
BACKGROUND
Approximately half of the patients with chronic heart failure (CHF) show preserved systolic function, but less is known about CHF with preserved ejection fraction (EF).


RESULTS
In a retrospective analysis, patients with CHF who had been admitted to hospital were divided into 2 groups: reduced EF (EF < or = 40%) and preserved EF (EF >40%). The rate of preserved EF was 53.5% and those with preserved EF were older, more likely to be female, and had a lower serum hemoglobin concentration than those in the reduced EF group. In the multivariate analysis, only older age was independently related to CHF with preserved EF. CHF patients with preserved EF who were successfully discharged from hospital and then followed at the outpatient clinic were reviewed and re-hospitalization for CHF was examined by Cox hazard univariate analysis, which showed that prior CHF hospitalization, absence of hypertension, and non-use of angiotensin-converting enzyme inhibitor (ACEI) and/or angiotensin-receptor blocker (ARB) were predictors. In the multivariate analysis, non-use of ACEI/ARB was the sole predictor for CHF re-hospitalization.


CONCLUSIONS
CHF patients with preserved EF are older than those with reduced EF and use of ACEI/ARB prevents their re-hospitalization.
Komukai
Kimiaki
K
Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan. komu@jikei.ac.jp
Yagi
Hidenori
H
Ogawa
Takayuki
T
Date
Taro
T
Morimoto
Satoshi
S
Kawai
Makoto
M
Hongo
Kenichi
K
Taniguchi
Ikuo
I
Yoshimura
Michihiro
M
D000367:Age Factors; D000368:Aged; D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D002908:Chronic Disease; D005260:Female; D006333:Heart Failure / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission; D016016:Proportional Hazards Models; D012084:Renin-Angiotensin System / Q000187:drug effects*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013318:Stroke Volume; D013997:Time Factors; D016896:Treatment Outcome
D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors